This is the first report of successful transcatheter closure of complex multiple ASDs under the 3D echo-x-ray navigation guidance. Transcatheter closure of multiple ASDs remains challenging because of complicated techniques, including the risk of incorrect device delivery into unexpected defects. The 3D echo-x-ray navigation system integrates TEE and fluoroscopy images (1), identifying the shape and location of ASDs evaluated by 3D TEE on fluoroscopy. This system provides more comprehensible image, and contributes to valuable guidance in the approach to complex multiple ASDs.

Appendix

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Footnotes

All authors have reported that they have no relationships relevant to the contents of this paper to disclose.